Provider Demographics
NPI:1790272144
Name:ASKINS, JILL (HIS)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:ASKINS
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OTTAWA
Mailing Address - State:OH
Mailing Address - Zip Code:45875-1773
Mailing Address - Country:US
Mailing Address - Phone:419-523-6916
Mailing Address - Fax:419-523-3845
Practice Address - Street 1:125 W MAIN ST
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:OH
Practice Address - Zip Code:45875-1773
Practice Address - Country:US
Practice Address - Phone:419-523-6916
Practice Address - Fax:419-523-3845
Is Sole Proprietor?:No
Enumeration Date:2018-04-20
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02941237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH341669370OtherFEDERAL TAX ID NUMBER